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The Promise of Health Care Reform for People with Mental Health and Substance Use Disorders *********************** Shel Gross, MPA Director of Public Policy. Mental Health America of WI. We’ve been asking to be treated as first class citizens; ACA does that. -National Council webinar.

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Mental health america of wi

Mental Health America of WI


The bottom line

We’ve been asking to be treated as first class citizens; Health and Substance Use Disorders

ACA does that.

-National Council webinar

The Bottom Line


Private insurance regulation
Private Insurance Regulation Health and Substance Use Disorders

  • No pre-existing condition

    exclusions

  • Guaranteed issue

  • Premiums can’t be based on health status

  • Plans offered on exchanges must include MH/SA benefits at parity


Integration

Growing recognition that we can’t bend the cost curve without addressing chronic health conditions

And

We can’t address chronic health conditions without addressing mental health

Integration


Integration1
Integration without addressing chronic health conditions

  • State option for “health homes” for people with SMI; 90% federal funding for 2 years.

  • Post-partum depression campaign.

  • Centers for Excellence on Depression.

  • Prevention services at no cost include depression and substance use screening.


Medicaid exchanges
Medicaid/Exchanges without addressing chronic health conditions

  • Allows expansion of Medicaid to 133% FPL with enhanced federal funding.

  • Allows Medicaid to cover non-disabled adults without dependent children.

  • Along with formation of

    exchanges can reduce the

    uninsured by more than half.


Largest share of expansion pop are childless adults
Largest share of Expansion Pop. Are ‘Childless Adults’ without addressing chronic health conditions


Prevalence of behavioral health conditions among uninsured adults ages 18 64 with incomes 400 fpl
Prevalence of Behavioral Health Conditions Among Uninsured Adults Ages 18-64 with Incomes <400% FPL


Mh sa prevalence in the medicaid expansion pop
MH/SA Prevalence in the Medicaid Expansion Pop. Adults Ages 18-64 with Incomes <400% FPL

SAMHSA Data: see citation


Mh sa prevalence in the exchange population
MH/SA Prevalence in the Exchange Population Adults Ages 18-64 with Incomes <400% FPL


Will the promise be realized

Will the Promise Be Realized? Adults Ages 18-64 with Incomes <400% FPL


Status of medicaid expansion
Status of Medicaid Expansion Adults Ages 18-64 with Incomes <400% FPL

  • 27 states currently not moving forward or still debating Medicaid expansion.

  • If they don’t expand an estimated 6.4 million fewer people would gain coverage.

  • This represents nearly two-thirds of the potential reduction in the uninsured tied to the expansion.

    Analysis prepared by the Urban Institute for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured


Status of medicaid expansion1
Status of Medicaid Expansion Adults Ages 18-64 with Incomes <400% FPL


Status of exchanges
Status of Exchanges Adults Ages 18-64 with Incomes <400% FPL


Outreach challenge
Outreach Challenge Adults Ages 18-64 with Incomes <400% FPL

  • Even in States with expanded coverage, research has shown that individuals with MH or SU conditions remain disproportionately likely to be uninsured.

  • According to Massachusetts Bureau of SA Services 20-25% of acute service presentations (primarily detox) are uninsured. These are disproportionately young men who are otherwise physically healthy.


Citations
Citations Adults Ages 18-64 with Incomes <400% FPL

  • MH/SA Prevalence Data: 2008-2011 National Survey of Drug Use and Health; 2011 American Community Survey.

  • State Exchange Map: National Academy of State Health Policy.


Contact info
Contact Info Adults Ages 18-64 with Incomes <400% FPL

Shel Gross

Mental Health America of WI

608-250-4368

[email protected]


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